Risk Adjustment (RA) FAQ
Guidance for FAQ regarding Risk Adjustment Operations and Policy
Program Area: Risk Adjustment (RA)
Question: How does an enrollee's metal level factor into Risk Adjustment (RA) calculations?
Answer: The RA model provides different plan liability cost factors for calculation of enrollee risk scores based on the type of metal plan in which the person is enrolled. For additional information, the RA program area has published two (2) computer-based training (CBTs) located here Risk Scores Part One (1) https://www.regtap.info/reg_librarye.php?i=2141&type=v and Risk Scores Part Two (2) https://www.regtap.info/reg_librarye.php?i=2751&type=v.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 22, 2019
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